Latest / Health with Hashimoto’s - Thyroid or Immune Education for Autoimmune Thyroid Disease / October Slide: Why Fall Hits Your Hashimoto’s Harder ⎸ Ep. 220
Transcript
- 0:00On October 1st every single year, I see so many social media quotes and pictures
- 0:06of beautiful fall colors with Anne of Green Gables saying, I am so glad I live
- 0:12in a world where there are Octobers.
- 0:14I also love October. I love the fall. It's so beautiful.
- 0:18And I really love it when all of the mosquitoes die so you can go outside on
- 0:22a walk and not get bitten.
- 0:24I really like that part too.
- 0:26But in the autoimmune world, there are a lot of people who also start talking
- 0:31about the October slide.
- 0:33I do have an old podcast episode about this, and I have not turned that one
- 0:39into a blog post. So we're going to recap it today.
- 0:43It's episode 120. But I went through all of the research again to see if there's
- 0:48any new information. And so that's what we're talking.
- 0:52Slide. Is it a real thing? What contributes to it? And how can you protect yourself
- 0:58and give yourself the best health in the fall and winter?
- 1:03Maybe you got a prescription and a follow-up appointment for six weeks later,
- 1:07or maybe you got told that your
- 1:08numbers are fine for now and we're just going to keep an eye on things.
- 1:12Either way, your provider probably did not tell you that Hashimoto's is two things and not one.
- 1:17It's a thyroid that can't keep up because it's also an immune system that's attacking the thyroid.
- 1:22Medication can help handle the first, but the second one is all yours to work
- 1:26on. You are the CEO of your own health.
- 1:29You can start working on that immune system side before your labs say that you have to.
- 1:34Hi, I'm Esther Yunkin. I am a registered nurse. I've been a nurse for 25 years
- 1:38and I am the host of the Health with Hashimoto's podcast.
- 1:41I am the nurse who helps you sort your Hashimoto's into thyroid or immune. Let's sort.
- 1:46When I hear of something happening cyclically from a client,
- 1:52like they tell me every single fall, I feel worse.
- 1:55When I hear it from one client, it's interesting and we talk about patterns
- 1:59and what she can do and what might lead into that pattern.
- 2:04When I start hearing it from multiple people, I go to the literature.
- 2:08Like, is this a common thing?
- 2:11Do I need to talk about it on the podcast? Are a lot of people dealing with this?
- 2:16That is one way that I develop episode ideas for you.
- 2:20And today's episode is inspired by some of those conversations.
- 2:25I kept hearing people talk about feeling worse in the fall. And I also experienced it.
- 2:31A couple years ago, I first noticed that I was just kind of flat.
- 2:36I was not depressed, but I was just feeling like I was existing instead of like my normal self.
- 2:42And it wasn't related to my menstrual cycle. I mean, that's the first thing you look at, right?
- 2:47If you're feeling off, the first thing that I usually wonder is where am I in my cycle?
- 2:52Because often that explains it but that that year that flat emotion was not
- 3:00explained by my menstrual cycle and it was also reflected by a couple people
- 3:04saying that they felt worse.
- 3:06So I started investigating what is going on and is this common for a lot of people?
- 3:11And it turns out that it is common enough that it has a name.
- 3:17And the name is the October slide.
- 3:21Now you will see this on social media primarily.
- 3:25I have not found it in any research that I looked at.
- 3:30It's just, it's like something that people talk about on social media and it's
- 3:35widely understood in some autoimmune groups.
- 3:38But yet, you know, it's not a diagnosis. It's not something that your doctor
- 3:42is going to say, oh, you're going into the October slide.
- 3:46So what is the October slide? Number one, it is personal.
- 3:50Like I said, it's not a diagnosis. It's not something that happens across the
- 3:54board, but it's common enough that it has a name.
- 3:57And the slide part is actually an acronym that stands for several things that
- 4:03happen or that change as we move into fall and winter.
- 4:08And the S starts back in September. Or if you live in the south,
- 4:13it starts even in August, which is school.
- 4:16School or work stress seems to increase in the fall.
- 4:21Another thing that happens is L, low barometric pressure.
- 4:24The I is illnesses increase. And of course they do. Everybody is inside in the winter.
- 4:30The D, days darken, and vitamin D drops.
- 4:34And E is related to a couple of those things, exercise ebbs.
- 4:40So the S-L-I-D-E stands for school or work stress increases.
- 4:44The L, low barometric pressure.
- 4:46I, illnesses increase. D, days darken, and vitamin in D drops, and E, exercise ebbs.
- 4:53Now look at your own life. Do you have any of those five things going on? Probably do.
- 5:00I mean, if you live in the Northern Hemisphere, your days are getting darker.
- 5:04They just are. Unless you live right around the equator where you have pretty
- 5:08consistent day and night throughout the year.
- 5:12But most of us live somewhere away from the equator and our daylight changes
- 5:18as we get into fall. If you are in the southern hemisphere, and I know some
- 5:21of my listeners are, then you are moving into spring.
- 5:25And so your days are getting longer. But here's the thing.
- 5:29When I looked at the research, I actually had one of the AIs scroll through
- 5:35a ton of research for me. And then yes, I did go investigate it and make sure
- 5:39that it was not hallucinating, that it was pulling the real stuff.
- 5:42I use several different AIs depending on what I'm doing. And I use perplexity
- 5:46if I want a lot of the like PubMed and the research, the actual scholarly articles
- 5:54scrolled, I used perplexity.
- 5:56So I asked perplexity about this, and yes, I, of course, double-checked it.
- 6:00But what it said is actually that the October slide, while it is talked about
- 6:06a lot in autoimmune circles, the research says that actually spring is worse.
- 6:13So there was a study done on multiple sclerosis, on people with multiple sclerosis,
- 6:17and fall was the best time for people who have multiple sclerosis.
- 6:24Generally, of course, in any single study and in any single disease,
- 6:29you are always an individual. There will always be bio-individual experiences and results.
- 6:36So in general, multiple sclerosis feels better in the fall, worse in the spring.
- 6:42Rheumatoid arthritis, again, people are feeling better in the fall.
- 6:47And these were some pretty big studies, one of the ones that they looked at
- 6:51was over 12,000 patients, and they felt better in the fall, worse in the spring.
- 6:58Lupus was also studied. And while some of the people had some changes in the
- 7:05fall, October itself was not like a peak.
- 7:10Inflammatory bowel disease has also been looked at for seasonal changes.
- 7:16And there is not a consistent pattern with the seasons.
- 7:21Okay, but you're like, Esther, I don't have those autoimmune diseases.
- 7:25I have Hashimoto's. Hashimoto's is an autoimmune disease.
- 7:29It is my immune system attacking my thyroid.
- 7:31Why are you talking about all of the other ones?
- 7:33Well, because I wanted to look for patterns in autoimmune diseases in general.
- 7:38But what about Hashimoto's? What about your thyroid specifically?
- 7:43And it is a good question for people who have hypothyroidism.
- 7:49Your TSH generally goes up in the winter.
- 7:53So is there an October slide, or maybe it's, you know, November,
- 7:57December, January, I don't know, for people with Hashimoto's?
- 8:01I can't tell you that from the article that I have, but the research article,
- 8:06it was published in 2021 in the Journal of Chronobiology International.
- 8:13So these four researchers, their goal was to figure out if there is a seasonal
- 8:18change with TSH and all thyroid hormone levels.
- 8:22So they wanted to know T3, T4, free T3, free T4. They looked at all five of
- 8:29those labs and they found that TSH goes up in the winter.
- 8:36They also found that free T4 is higher in the autumn than in the winter.
- 8:42So let's review these five labs quick.
- 8:46TSH is your brain asking for more thyroid hormone.
- 8:50The higher it is, the more your brain is asking for more. It doesn't mean it has more.
- 8:56The higher your TSH is, the more requests are going out for please give me more.
- 9:02Free T4 is the amount of thyroid hormone, specifically the T4 hormone that is
- 9:09circulating in your blood available to be used.
- 9:13Free T3 is the available T3 hormone circulating in your blood available to be used.
- 9:21And to review, your thyroid creates mostly T4.
- 9:25Your mostly liver converts that to T3. T3 is like the ignition key for your cell.
- 9:32So TSH, your brain asking for more.
- 9:36T4, what your thyroid produces. Free T4, how much is available floating around in your blood.
- 9:43T3 is the active form. And free T3 is the stuff floating around in your blood available to be used.
- 9:50So I do have episodes about all of those, and I explain them in much more detail.
- 9:56But essentially, this research found that TSH, so the amount of requests going
- 10:03out for more, is higher in the winter than the other seasons.
- 10:08And also, free T4 is highest in the fall.
- 10:12Why is that? They didn't go into that. You know, research articles,
- 10:17if you read, if you start reading research, they almost always end in,
- 10:21this is what we found, and this is where we think that other people should study.
- 10:25Most research articles are very, very narrow in their scope.
- 10:29This research article did not talk about October. They didn't mention the word slide.
- 10:35They were just looking at seasonal changes and TSH is higher.
- 10:40So where does that leave you? Well, it leaves you, as always,
- 10:45as the CEO of your own health.
- 10:48Your job as somebody who has been diagnosed with Hashimoto's,
- 10:53or really as somebody who is alive, your job is to look at the overview of your
- 10:59own health, to look for patterns, and to
- 11:03develop goals and a plan for how you're going to have the best health.
- 11:08So my goal for the winter is to feel normal.
- 11:13If you've heard my story, if you've heard my stories about my flare-ups of Hashimoto's,
- 11:17you know that the cold is a trigger for me.
- 11:20So every winter, I feel worse. I have some like flat mood.
- 11:26I have some skin issues. I'm just more tired.
- 11:29I know that the winter itself, and pretty sure it's the cold, not the daylight.
- 11:36That is my biggest thing. But what is it for you? Like what are your seasonal patterns?
- 11:42Do you have this seasonal cyclical pattern of feeling worse in the fall or in the winter?
- 11:50If you do, if you can reflect back on the last couple falls or the last couple
- 11:56winters and say, oh yeah, I often do feel worse in the winter,
- 12:00then you get to look at, okay, what else is going on?
- 12:04Maybe one of these slide things. School, barometric pressure,
- 12:08illnesses, the days to darken, vitamin D, and exercise.
- 12:12Are any of those in your control?
- 12:15It's probably not in your control whether you go to school or go to work,
- 12:18whether you homeschool or whether you have kids in the public school,
- 12:22whatever your situation is.
- 12:23If you have minors, school is just part of life.
- 12:28You can't change that. Same with work. You might be able to change jobs,
- 12:32but earning an income going to work, that's probably not going to change.
- 12:37So while parts of it are in your control, the school and work stress are,
- 12:42they're just part of life and not in just October or November or December.
- 12:48The low barometric pressure, you cannot change the weather.
- 12:53That it just is what it is. Illnesses increasing. Okay, that one,
- 12:58you cannot change what anybody else is doing, but you can protect yourself.
- 13:04When illnesses increase, what can you do?
- 13:08For myself, when I worked in the ER or anywhere in the hospital,
- 13:12every single fall, somebody would come around asking if everybody wanted a flu shot.
- 13:17So I did a lot of research and I found that in general, probiotics were more
- 13:25effective to protect people from respiratory illnesses than a vaccine.
- 13:31I also found out that adequate levels of vitamin D, and so when I say adequate,
- 13:36I'm thinking 80-ish, but I don't remember the study. This has been,
- 13:40oh goodness, I started looking at probiotics and vitamin D and flu.
- 13:45Probably 20 years ago. I haven't been a nurse for 25 years. I started looking
- 13:50at supplements and micronutrients and diet and things back just a year after
- 13:57graduating from nursing school.
- 13:59So I don't remember when I first came across these studies, but it was probably 20 years ago.
- 14:05And I saw a couple different studies. I remember writing down at least three
- 14:10different journal articles when the nurse would come around through the hospital
- 14:14asking if I wanted or if I was going to refuse a flu shot. I was like,
- 14:18here are the research articles.
- 14:20And from what I read, probiotics are more effective and adequate amounts of
- 14:27vitamin D are more effective.
- 14:28So both of them together, I am doing that.
- 14:31And I feel like I am protecting myself from respiratory problems more than this.
- 14:39Shot that you want to give me.
- 14:41And so I refused it every year. Every year except for one.
- 14:45I still remember where I was standing and I remember which ER I was in.
- 14:49And I was at the end of like a long stretch of night shift, 12 hour night shift.
- 14:55Or maybe at that ER I was working 16s. I don't remember. I was a traveler at that time.
- 15:01And so they work you hard, which is fine. But I was tired.
- 15:05And it was first thing in the morning, the nurse came around.
- 15:09So, you know, I'm at the very end of my shift, at the end of a stretch of days,
- 15:14and I was just tired and I didn't argue with them.
- 15:17I like put up a little argument and told them the probiotics and the vitamin D.
- 15:23And for some reason, I gave in that year and it is the sickest winter I've ever had.
- 15:29I got, yeah, not going to go there. You can do your own research on that.
- 15:34But know that there are things that you can do to protect yourself from other
- 15:38people's germs and viruses in the winter.
- 15:41I do have an episode about that.
- 15:44It is episode 14. I've also done a webinar on it, just going through the different
- 15:48layers of protection that you can do on your own. Because again,
- 15:53we're not trying to control somebody else's health.
- 15:56You are looking at what is in your own control.
- 16:00Do you have control of S-L-I-D-E? Do you have control over school,
- 16:08over the barometric pressure, over illnesses, over the days getting darker, over exercise?
- 16:15You don't have control over all of those, but there are things that you can
- 16:18do. So episode 14, now that I have mentioned it on the podcast,
- 16:22I'll probably go back and do that blog post next.
- 16:26I'm trying to go in order that people find the blogs, like an order of popularity
- 16:31as I put each one of them out there. So I'll probably try to do 14 this week
- 16:37so that you can just hit that and see.
- 16:39But of course, the podcasts are always out.
- 16:44So do you have control over illnesses?
- 16:48Well, you have control over some of your own protection, but not necessarily
- 16:53over, you know, if other people are getting sick.
- 16:56You do not have control over the days getting darker. That is dependent on where
- 16:59you live. But you do have control over your vitamin D levels.
- 17:03I have a bunch of episodes, I mean a bunch, probably like three,
- 17:07talking about vitamin D because it is so crucial for your overall health and wellness.
- 17:14It is crucial for your immune system and.
- 17:17It does go down in the winter. It also doesn't go up in the summer if you are
- 17:22not outside a lot, or if you use a lot of sunscreen, if you protect yourself from the sun.
- 17:26Vitamin D is super important, and that is in your control.
- 17:32I recommend that everybody gets their vitamin D level checked in the fall,
- 17:36and then you supplement appropriately.
- 17:39Back again, 15, 20 years ago, I heard people, this was back when the vitamin
- 17:45D council was a thing, you know, a group of experts all coming together.
- 17:50And they specifically said you cannot get enough vitamin D from food unless
- 17:55you're eating a bunch of, I think they said anchovies or sardines.
- 17:59But I don't eat those tiny fish. I don't eat tin fish really.
- 18:03So I supplement. And again, go to those episodes about vitamin D so that you
- 18:09can learn about what you can do for your own health for the D of October slide.
- 18:14Episode 9 is probably your best bet to start. In that one, I talk about low
- 18:19vitamin D and Hashimoto's.
- 18:21I do have another one. I think it's episode 62.
- 18:25Yep, 62. And that talks about how to pick a vitamin D supplement.
- 18:30So we're on to the E of slide.
- 18:34Do you have control over your exercise ebbing. Yes, you do.
- 18:39You don't have control over the weather. So if you go outside,
- 18:43you know, every day in the summer for exercise, and then it gets cold and rainy
- 18:47and snowy and sleety, you don't want to go outside. I understand.
- 18:50But you still have control over how active you are.
- 18:54And how active you are impacts your immune system.
- 18:58So let's work on the things that we do have control over.
- 19:03And just know that you're not imagining things.
- 19:07If you feel like your health, if your Hashimoto's changes in the fall,
- 19:13it's probably true for you.
- 19:15And then you get to look at, well, why? What kind of patterns are here?
- 19:19And maybe S-L-I-D-E impacts your health.
- 19:23School, low barometric pressure, illnesses around you, the days getting darker
- 19:28and vitamin D and exercise changes.
- 19:31Some of these are obvious, some of them you have to look into,
- 19:34but control the controllables.
- 19:36You are the CEO of your own health.
- 19:39And I want you to look outside on October 1st and all throughout October,
- 19:44and I want you to be saying what Anne of Green Gables says, which is,
- 19:49I'm so glad I live in a world where there are Octobers.
- 19:53That's it for today. If you are ready to sort your Hashimoto's into thyroid
- 19:57or immune, start with Hashimoto's Decoded, and then come talk about it in the free community.
- 20:02Both links are in the show notes. I'll see you next week.
- 20:05This podcast is for informational and educational purposes only.
- 20:09Please discuss any questions or concerns with your trusted healthcare professional.